Contact us for an appointment:
905-878-5882
| info@miltoneyeandvisioncare.com
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Pediatric Optometrist
Eye Spa Treatments
Eyewear
Eyeglasses & Frames
Contact Lenses
Team
Vision Info
Cataracts
Eye Styes
Eye Floaters
Retinal Detachment
Glaucoma
Diabetic Retinopathy
Dry Eyes
Retinitis Pigmentosa (RP)
Pools & Hot Tubs
Sun Exposure and Tanning
Macular Degeneration
Astigmatism
Blepharitis
News
Find Us
Services
Pediatric Optometrist
Eye Spa Treatments
Eyewear
Eyeglasses & Frames
Contact Lenses
Team
Vision Info
Cataracts
Eye Styes
Eye Floaters
Retinal Detachment
Glaucoma
Diabetic Retinopathy
Dry Eyes
Retinitis Pigmentosa (RP)
Pools & Hot Tubs
Sun Exposure and Tanning
Macular Degeneration
Astigmatism
Blepharitis
News
Find Us
Order contact lenses
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Order contact lenses
Order contact lenses
Milton Eye and Vision Care
2015-01-14T20:02:29+00:00
Our office provides two convenient ways of ordering Contact Lenses. You can either phone our office (905) 878-5882 or fill out the form below. Our staff is ready to assist you.
All the fields followed by a * are mandatory.
Referred by
Title
Mrs
Miss
Mr
First Name
*
Last Name
*
Phone ((###)###-####)
*
Email
*
Date of birth
*
Age Range
Please choose
0-18
18-44
44-64
65+
When was your last eye exam?
Type of lenses required
*
Please name the product.
Eyes
*
Left
Right
Both
Quantity
1 year
6 months
3 months
Or number of boxes
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